A Comparative analysis of oncologic safety between conventional total mastectomy(CTM) and skin/nipple-sparing mastectomy(SSM/NSM) techniques

초록

Background: With increasing attention to aesthetic and quality-of-life outcomes in breast cancer surgery, skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) have gained popularity as alternatives to conventional total mastectomy (CTM). However, concerns remain regarding their oncologic safety compared with CTM. This study aimed to evaluate the long-term oncologic outcomes of SSM/NSM versus CTM in patients with breast cancer. Material and methods: A total of 383 patients who underwent total mastectomy at Korea University Ansan Hospital between July 2010 and February 2020 were retrospectively reviewed. Patients who underwent palliative surgery were excluded. Among them, 104 patients received NSM or SSM, and 279 underwent conventional total mastectomy (CTM). Clinicopathologic characteristics and survival outcomes were compared between the two groups. Results: In both surgical groups, higher N stage was associated with increased mortality. However, there were no statistically significant differences in overall survival between the SSM/NSM and CTM groups. Patterns of recurrence and disease-free survival were also comparable between the two surgical approaches. Conclusions: SSM and NSM showed no inferiority to CTM in terms of oncologic safety and clinical outcomes. These techniques may serve as safe and effective alternatives to conventional mastectomy, providing favorable cosmetic outcomes without compromising oncologic efficacy. No conflict of interest